Abstract

OBJECTIVE
We sought to determine whether, among women with gestational diabetes mellitus, referral to a telephonic nurse management program was associated with lower risk of macrosomia and increased postpartum glucose testing.
STUDY DESIGN
There was medical center-level variation in the percent of patients referred to a telephonic nurse management program at 12 Kaiser Permanente medical centers, allowing us to examine in a quasi-experimental design the associations between referral and outcomes.
RESULTS
Compared with women from centers where the annual proportion of referral nurse management was <30%, women who delivered from centers with an annual referral proportion >70% were less likely to have a macrosomic infant and more likely to have postpartum glucose testing (multiple-adjusted odds ratio, 0.75; 95% confidence interval, 0.57-0.98 and multiple-adjusted odds ratio, 22.96; 95% confidence interval, 2.56-3.42, respectively).
CONCLUSION
Receiving care at the centers with higher referral frequency to telephonic nurse management for gestational diabetes mellitus was associated with decreased risk of macrosomic infant and increased postpartum glucose testing.

Links

Publisher Full Text

Authors

Ferrara A, Hedderson MM, Ching J, Kim C, Peng T, Crites YM

Institution

Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA. Assiamira.Ferrara@kp.org

Source

American journal of obstetrics and gynecology 206:6 2012 Jun pg 491.e1-5

MeSH

Adolescent
Adult
Blood Glucose
Diabetes, Gestational
Directive Counseling
Female
Fetal Macrosomia
Glucose Tolerance Test
Humans
Infant, Low Birth Weight
Infant, Newborn
Logistic Models
Odds Ratio
Postnatal Care
Pregnancy
Prenatal Care
Referral and Consultation
Registries
Telemedicine
Treatment Outcome
Young Adult

Pub Type(s)

Evaluation Studies
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

22631866